Advances in molecular-targeted therapy for unresectable pancreatic cancer / 临床肝胆病杂志

Pancreatic cancer is one of the most prevalent malignant tumors of the digestive system， and its incidence and mortality rates are increasing year by year. Most patients with pancreatic cancer are unable to receive surgery due to the advanced stage. Although chemotherapy regimens based on gemcitabine and fluorouracil have prolonged the survival time of patients to some extent， some patients cannot tolerate chemotherapy and hence lose the opportunity for treatment. With the advent of the era of precision medicine， molecular-targeted therapy has exhibited an excellent therapeutic efficacy and has thus become one of the most important treatment techniques for tumors； however， due to the high heterogeneity of pancreatic cancer and its complicated tumor microenvironment， molecular-targeted therapy for pancreatic cancer has not achieved notable results. Therefore， it is imperative to seek new therapeutic targets and medications to overcome this issue. This article reviews the latest advances in the research on molecular-targeted therapy for unresectable pancreatic cancer based on common molecular targets and tumor immunity-related therapeutic targets， in order to provide new treatment strategies for patients with pancreatic cancer.

Research Progress of Chimeric Antigen Receptor NK Cells in Treatment of Lymphoma / 肿瘤防治研究

Adoptive cell immunotherapy has been a hot spot in tumor research in recent years. Chimeric antigen receptor T cells (CAR-T) have achieved great success in hematological tumors and have changed the current tumor treatment landscape to a certain extent. However, the application of CAR-T therapy in clinics is limited due to its serious side effects and high treatment costs. Natural killer (NK) cells are important immune cells in the body and have native cytotoxicity and well safety. NK cells based on CAR engineering (CAR-NK) have shown powerful anti-tumor activity and safety in preclinical research and could be the next generation of CAR platform-based cellular immunotherapy. This review will systematically introduce the current research status of CAR-NK cells in lymphoma.

Mechanism of Jiaotai Pills in treatment of depression based on quantitative proteomics / 中国中药杂志

This study aimed to investigate the effect of Jiaotai Pills on protein expression in the hippocampus of the rat model of chronic unpredictable mild stress(CUMS)-induced depression by quantitative proteomics and explore the anti-depression mechanism of Jiaotai Pills. The SD rats were randomized into control, model, Jiaotai Pills, and fluoxetine groups(n=8). Other groups except the control group were subjected to CUMS modeling for 4 weeks. After 4 weeks of continuous administration, the changes of behavior and pathological morphology of the hippocampal tissue were observed. Proteins were extracted from the hippocampal tissue, and bioinformatics analysis was performed for the differentially expressed proteins(DEPs) identified by quantitative proteomics. Western blot was employed to verify the key DEPs. The results showed that Jiaotai Pills significantly alleviated the depression behaviors and hippocampal histopathological changes in the rat model of CUMS-induced depression. A total of 5 412 proteins were identified in the hippocampus of rats, including 65 DEPs between the control group and the model group and 35 DEPs between the Jiaotai Pills group and the model group. There were 16 DEPs with the same trend in the Jiaotai Pills group and the control group, which were mainly involved in sphingolipid, AMPK, and dopaminergic synapse signaling pathways. The Western blot results of Ppp2r2b, Cers1, and Ndufv3 in the hippocampus were consistent with the results of proteomics. In conclusion, Jiaotai Pills may play an anti-depression role by modulating the levels of Ppp2r2b, Cers1, Ndufv3 and other proteins and regulating sphingolipid, AMPK, and dopaminergic synapse signaling pathways.

Anti-depression mechanism of Zuojin Pills:based on UHPLC-TOF-MS, network pharmacology, and experimental verification / 中国中药杂志

This study aims to explore the anti-depression mechanism of Zuojin Pills based on the plasma constituents, network pharmacology, and experimental verification. UHPLC-TOF-MS was used for qualitative analysis of Zuojin Pills-containing serum. Targets of the plasma constituents and the disease were retrieved from PharmMapper and GeneCards. Then the protein-protein interaction(PPI) network was constructed and core targets were screened for GO term enrichment and KEGG pathway enrichment. Cytoscape 3.7.2 was employed construct the "compound-target-pathway" network and the targets and signaling pathways of Zuojin Pills against depression were predicted. CUMS-induced depression mouse model was established to verify the key targets. The results showed that a total of 21 constituents migrating to blood of Zuojin Pills were identified, which were mainly alkaloids. A total of 155 common targets of the constituents and the disease and 67 core targets were screened out. KEGG enrichment and PPI network analysis showed that Zuojin Pills may play a role in the treatment of depression through AMPK/SIRT1, NLRP3, insulin and other targets and pathways. Furthermore, the results of animal experiments showed that Zuojin Pills could significantly improve the depression behaviors of depression, reduce the levels of IL-1β, IL-6 and TNF-α in hippocampus and serum, activate AMPK/SIRT1 signaling, and reduce the protein expression of NLRP3. In conclusion, Zuojin Pills may play a role in the treatment of depression by activating AMPK/SIRT1 signaling pathway, and inhibiting NLRP3 activation and neuroinflammation in the hippocampus of mice.

Egr-1 Enhances Drug Resistance of Breast Cancer Cells by MDR1 Dependence

Abstract Paclitaxel (PTX) is one of the most effective drugs used in the treatment of breast cancer. Nonetheless, the appearance of MDR1 (multidrug resistance 1) in tumor cells has become a significant hindrance for efficacious chemotherapy. In this study, we show that the expression level of Egr-1 (early growth response gene-1) in cancer tissues (from paclitaxel chemotherapy failure patients) and MCF-7/PTX cells (the breast cancer cell line that was resistant to paclitaxel) was increased. Cell proliferation assay and apoptosis assay revealed that Egr-1 could promote cell growth and inhibit apoptosis in MCF-7/PTX. Mechanistic studies indicated that Egr-1 could bind to the proximal MDR1 promoter and enhance MDR1 transcription. These findings indicate that paclitaxel induced Egr-1 accumulation and upregulated the expression of MDR1, thereby inducing the drug resistance in MCF-7/PTX. Our results suggest a novel pathway by which paclitaxel induces MDR1 expression, possibly illuminating a potential target pathway for the prevention of MDR1-mediated drug resistance.

Apigenin inhibits liver fibrosis through PDK1/AKT signaling pathway in mice / 中国药理学通报

Aim To evaluate the therapeutic effect of apigenin on liver fibrosis in mice anrl the pharmacologi¬cal mechanism.Methods Carbon tetrachloride ( CC14) -induced liver fibrosis mouse model was estab¬lished.The mice were divided into six groups of con¬trol, model, silibinin(55 mg • kg 1 • d 1 ) , apigenin in high dosage (60 mg • kg 1 • d 1 ) , apigenin in mid¬dle dosage( 30 mg • kg 1 • d 1 ) and apigenin in low dosage( 15 mg • kg 1 • d 1 ).The general life status, body weight and liver coefficient of the mice in every group were recorded.HE staining, Masson staining, immunohistochemistry and Western blot were used to e- valuate the effect of apigenin on the pathological chan¬ges, the markers related to epithelial-mesenchymal transition and signaling pathways of liver tissues.Re¬sults In CCI4-induced liver fibrosis mice, middle and high-dosage of apigenin could improve the general life status, increase body weight, decrease liver coeffi¬ cient, and significantly improve liver lesions.Middle and high-dosage of apigenin significantly increased the expression of the epithelial marker protein E-cadherin and significantly decreased the expression of the mes¬enchymal marker protein Vimentin in liver tissues of mice with the disease.The further results showed that middle and high-dosage apigenin could significantly in¬hibit the expression of phosphorvlated PDK1 and phos- phorvlated AKT protein in liver tissues of model mice.Conclusions Apigenin can inhibit EMT by inhibiting PDK1/AKT signaling pathway, which plays an anti-fi- brosis role.The apigenin has the potential to be further developed as a drug to protect the liver and treat liver fibrosis.

Study on the diffusion of hydrogen fluoride in an electrolytic fluoride plant based on CFD numerical simulation method / 中华劳动卫生职业病杂志

Objective: Using CFD technology to grasp the distribution and diffusion of hydrogen fluoride in an electrolytic fluorine plant, provide guidance and scientific basis for enterprises to carry out occupational health management in enterprises, install hazardous substance alarm devices, and protect workers' occupational health. Methods: In July 2019, the diffusion law of hydrogen fluoride gas produced in an electrolytic fluorine plant is selected as the research object. Through the establishment of models and grids, the Fluent numerical simulation method is finally used to simulate the diffusion and distribution of hydrogen fluoride gas under ventilation conditions. Results: The results showed that the average concentration of hydrogen fluoride was 0.045 mg/m(3) in the workplace, and the absorbed zone height (1.5 m) was 0.02 mg/m(3) in the inspection channel, which was in accordance with the national standard. However, there is eddy current above the electrolyzer near the inlet, may lead to the accumulation of hydrogen fluoride gas. Conclusion: The research of CFD numerical simulation method on the distribution and diffusion of hydrogen fluoride concentration in electrolytic fluorine plant can be applied to the prevention, control and management of occupational hazards in electrolytic fluorine plant.

Comparable prognosis in different neonatal histidine-tryptophan-ketoglutarate dosage management / 中华医学杂志(英文版)

BACKGROUND@#Histidine-tryptophan-ketoglutarate (HTK) is a solution commonly used for organ transplantation. However, there is no certified fixed regimen for on-pump heart surgery in neonates. We aimed to retrospectively evaluate the outcomes related to different HTK dosages and to analyze the safety of high-dosage perfusion.@*METHODS@#A total of 146 neonates who underwent on-pump heart surgery with single-shot HTK perfusion were divided into two groups according to HTK dosages: a standard-dose (SD) group (n = 63, 40 mL/kg 60 mL/kg). Propensity score matching (PSM) was performed to control confounding bias.@*RESULTS@#The SD group had a higher weight (3.7 ± 0.4 vs. 3.4 ± 0.4 kg, P  0.05). The incidences of post-operative complications were not significantly different between the two groups. There were no significant differences in ventilation time, intensive care unit stay, and post-operative hospital stay (P > 0.05). Follow-up echocardiography outcomes at 1 month, 3 to 6 months, and 1 year showed that left ventricular ejection fraction and end-diastolic dimension were comparable between the two groups.@*CONCLUSIONS@#In neonatal on-pump cardiac surgery patients, single-shot HD (>60 mL/kg) HTK perfusion had a comparable heart protection effect and short-term post-operative prognosis as standard dosage perfusion of 40 to 60 mL/kg. Thus, this study provides supporting evidence of the safety of HD HTK perfusion.

Clinical Practice Guidelines of Rehabilitation: Methodological Quality / 中国康复理论与实践

@#Objective To evaluate the methodological quality of clinical practice guidelines of rehabilitation using Appraisal of Guidelines for Research and Evaluation (AGREE) II.Methods Clinical practice guidelines of rehabilitation were searched in databases such as PubMed, EMBASE, Wanfang database, CNKI, China Biology Medicine disc and related websites from medlive.cn, National Institute for Health and Care Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, World Health Organization, and Guidelines International Network from establishment to January 11, 2020. Two researchers reviewed literatures and assessed the methodological quality of the guidelines independently by using AGREE II; any disagreements needed to be discussed in a consensus meeting.Results A total of 84 guidelines were included in the study, with 67 foreign guidelines and 17 domestic guidelines. The average score rate for all the guidelines was 48.1%, in which 49.9% for the foreign guidelines and 40.7% for the domestic guidelines. In the six areas of AGREE II, the average score rate of the foreign guidelines was higher than that of domestic ones (|Z| > 2.034, P < 0.05), expect applicability; the average score rate of clarity and independence improved with the launch of AGREE Ⅱ ( Z > 2.130, P < 0.05). The average scores rate ranged from high to low followed as range and purpose (41.6%), clarity (39.9%), participants (24.5%), rigor (23.2%), independence (15.5%) and applicability (12.9%). Conclusion Clinical practice guidelines of rehabilitation is mainly of low quality by AGREE II. Guideline developers need to work after AGREE Ⅱ standard in the future.

Analysis of macrophage marker genes and their functions in triple negative breast cancer based on single cell sequencing / 医学研究生学报

ObjectiveAs the search for effective tumor markers has been the focus of current research, this paper aims to identify the macrophage marker genes in triple negative breast cancer (TNBC) tissue by single cell sequencing, and to analyze its biological processes and the key genes involved.MethodsFirstly, the GEO database was used to download the data set GSE118389 to obtain the required single cell data, and the dimension reduction of PCA and T-SNE was used to obtain 15 subsets of cells, and the marker genes of different subsets of cells were obtained. Then, gene ontology (GO) and KEGG enrichment analysis was performed on the macrophage marker genes to analyze the biological processes in which these genes may be involved. Finally, a protein-protein interaction (PPI) network was constructed to find key genes in each network, and the Kaplan-Meier Plotter database was used to analyze the prognosis of key genes, and the tumor immune assessment (TIMER) database was used to analyze the correlation between the expression level of key genes and the infiltration state of macrophages in TNBC cancer tissues.ResultsA total of 244 macrophage marker genes were obtained, mainly in the processes of neutrophil degranulation, neutrophil activation, amide binding, peptide binding and cell adhesion molecule binding, and four key genes CSF-1R, HLA-DQA1, OLR1 and LAPTM5 were further obtained. The overall survival rate of TNBC patients with high expression of CSF-1R, HLA-DQA1 and OLR1 was higher than those with low expression. Moreover, the expression levels of CSF-1R, LAPTM5 and OLR1 were positively correlated with the immune infiltration of macrophages.ConclusionMarkers may be an important target for conquering tumors in the future. In addition, CSF-1R, HLA-DQA1 and OLR1 can be used as an effective biomarker to predict the prognosis of TNBC patients and provide ideas for targeted therapy and immunotherapy for them.

Clinical evaluation of cervicectomy in the treatment of cervical intraepithelial neoplasia with cervicovaginal shortening / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the clinical efficacy of cervicectomy for cervical intraepithelial neoplasia(CIN)in patients with cervicovaginal shortening.METHODS: Retrospectively analyze the clinical data of the 120 cases of CIN treated in Shengjing Hospital of China Medical University from April 2014 to November 2018.Cervicectomy was performed because of cervicovaginal shortening caused by menopausal or peri-menopausal cervical atrophy or cervical surgery.The clinical treatment,efficacy and prognosis of the patients were reviewed.RESULTS: The mean age of the 120 patients was 55.2 years(range:35-77 years).The indications of operation included:persistent abnormal cervical cytology test(7),CIN2(42),CIN3(70),squamous carcinoma of the cervix(1);peri-menopausal and menopausal patients with obvious cervicovaginal atrophy(100),premenopausal patients with natural short cervix(2),and obvious cervicovaginal shortening caused by cervical surgery(18).The mean operating time was 23.2 min(range 10-30 min),the mean bleeding volume was 7.8 mL(range:5-20 mL),and the mean height of cervix resected was 2.59 cm(range:2-3 cm).No secondary injury,bleeding or other postoperative complications occurred during surgery;cervical postoperative wounds healed well;only one case developed cervical adhesion after surgery.The postoperative histologic diagnosis were compared with the preoperative histologic diagnosis,in which 45 degraded(37.50%),42 consistent(35.00%),and 33 upgraded(27.50%).HPV conversion rate 3 months after cervicectomy was 80.81%(80/99),and total HPV conversion rate was 88.89%(88/99).A total of 29 patients underwent secondary surgery,23 underwent total hysterectomy,and 6 underwent extensive hysterectomy and pelvic lymphadenectomy.All patients were followed up,once every 3 to 6 months,and median follow-up time was 29.5 months(range 4-59 months).All patients recovered well after surgery;only 2 cases showed positive margins,and only 2 cases of residual disease and 1 case of recurrence were found during follow-up.CONCLUSION: For patients with cervical intraepithelial neoplasia of cervicovaginal shortening,cervicectomy is a safe,effective and relatively microinvasive treatment.

Esophageal stent placement versus endoscopic incision for the treatment of refractory esophageal anastomotic stricture / 医学研究生学报

Objective Few reports are seen comparing esophageal stent placement (ESP) and the endoscopic incision method (EIM) in the treatment refractory esophageal anastomotic strictures (EAS) following esophageal carcinoma resection (ECR). This study was to evaluate the effect ESP versus that of EIM in the treatment of refractory EAS after ECR. Methods We retrospectively analyzed the clinical data on 50 cases of post-ECR refractory EAS treated by ESP (n = 32) or EIM (n = 18) in our Center of Digestive Medicine between January 2012 and December 2018. We recorded and compared the pre- and post-operative dysphagia scores, post-operative complications and follow-up results between the two groups of patients. Results Compared with the EIM group, the patients of the ESP group had a remarkably lower dysphagia score post-operatively (1.4±0.5 vs 1.0±0.0, P<0.01), a smaller diameter of the dilated esophagus ([19.9±1.8] vs [11.0±1.9] mm, P<0.01), higher incidence rates mild and severe chest pain (P=0.022), and a higher rate of relief of esophageal stricture at 12 months after surgery (P<0.05). Conclusion EIM can rapidly relieve the symptoms of esophageal anastomotic stricture, while ESP may achieve a longer duration of relief. Both of the procedures are safe for patients with refractory esophageal anastomotic stricture.

Obesity and surgical site infection following spine surgery: a Meta-analysis / 中国感染控制杂志

Objective To explore the influence of obesity in surgical site infection (SSI) following spine surgery.Methods Literatures on relationship between obesity and spine surgery were collected. Data were extracted, checked, and analyzed with STATA 11.0 software by two researchers independently, fixed-effect model and random-effect model were used to analyze the combined OR value and its 95％ confidence interval (95％CI). Results A total of 32 literatures involving 110 877 patients were included in the study. Most studies were thoracic or lumbar surgery. SSI rate in obesity group was higher than control group (OR, 2.56 [95％CI, 1.95-3.36]). Stratified analysis result showed that incidence of infection in obese Caucasians was 2.50 times higher than that in control group (95％CI, 1.77-3.52), obese people in Asia was 2.77 times higher than that of people with normal weight (95％CI, 1.81-4.22).Conclusion Among Caucasians and Asians, obese people are more likely to have SSI following spine surgery.

Effectiveness of semi-open suturation of vaginal stump in prevent the development of pelvic lymphocele after pelvic lymphadenectomy / 中国实用妇科与产科杂志

OBJECTIVE: To evaluate the effectiveness of semi-open suturation of vaginal stump in preventing pelvic lym-phocele after pelvic lymphadenectomy during gynecologic cancer surgery.METHODS:This study is a retrospectivestudy.Totally 348 patients with cervic cancer or endometrial cancer who underwent pelvic lymphadenectomy and/or para-aortic lymphadenectomy from January 2012 to September 2018 were divided into two groups according to the suturationof vaginal stump:102 patients were in the semi-open group and 246 patients were in the closed group.The two groupswere compared concerning the surgery time,harvested lymph node,drainage time,albumin level,hemoglobin content,and the incidence of lymphocele and symptomatic lymphocele.RESULTS:There were no differences between two groupswith respect to surgery time,harvested lymph node,drainage time,albumin level or hemoglobin content(P>0.05).Theincidence of lymphocele and symptomatic lyphocele in semi-open group was significantly lower than that in closed group(35.3%versus79.3%,3.9%versus19.5%,P<0.05);the average diameter of lymphocele in semi-open group was also sig-nificantly lower than that in closed group(4.1cm versus 5.9cm,P<0.05).CONCLUSION:The result of this study indicatesthat the application of semi-open saturation of vaginal stump is an effective way to reduce the incidence of pelvic lym-phocele after gynecologic malignancy,which is simple and with reliable effect.It doesn′t increase the incidence of postop-eration complications and deserves clinical application.

A study on the relationship between perceived organizational support, organizational identifi-cation and job engagement of non-establishment staff in public hospital / 中国卫生政策研究

Objective:To study the perceived organizational support,organizational approval impact on job engagement process and influence mechanism of non-establishment staff in public hospital under the background of China's personnel sys-tem,and provide reference for hospital managers to take measures to promote the staff's job involvement. Methods:650 non-es-tablishment staffs from three tertiary public hospitals in each of the six cities of Sichuan province were surveyed by issuing or-ganizational support questionnaires,organization approval scale and work input scale. Descriptive analysis,correlation analy-sis,regression analysis were performed with the help of SPSS 19.0,a three-variable structural equation model was established by using AMOS17.0. Results:The average score of organizational support of non-establishment staffs in public hospitals was (2.80 ±1.05),the organizational approval scale was(3.73 ±1.03)and job engagement was(2.99 ±1.58);and there was a sig-nificant positive correlation (P<0.01) between organizational approval and job engagement. It was also revealed that per-ceived organizational support had a direct effect on job involvement,and indirect effect on organizational approval as a partial mediation variable. Conclusion:Public hospitals have a low level of perceived organizational support,job involvement of non-establishment staffs,and public hospital administrators can promote the job engagement of non-establishment staffs in public hospital by improving the sense of organizational support and organizational identification.

Safety, efficacy and clinical value of endoscopic treatment for duodenal lesions / 中国内镜杂志

Objective To assess the safety, efficacy and the clinical value of endoscopic treatment for duodenal lesions. Methods 59 patients with duodenal lesions were treated by endoscope from December 2012 to December 2016. The clinical data were retrospectively analyzed. Results There were 31 male and 28 female patients, aged 17 ～ 81 (58.2 ± 13.3) years. The lesion location included the duodenal bulb (n = 24, 40.68％) and the descending part (n = 21, 25.42％). The diameter of the lesions ranged from 0.2 to 5.0 (1.4 ± 0.9). Thirty-nine (66.10％) lesions originated from the mucosa, including inflammatory/hyperplastic polyps (n = 18, 30.51％), villous/tubular adenoma (n = 6, 10.17％). Twenty (33.90％) lesions originated from the submucosa, including Brunner's glands adenoma (n = 4, 6.78％), ectopic pancreas (n = 5, 8.47％), lipoma (n = 4, 6.78％). There were 4 delayed bleeding, 5 intraoperative perforation. Two patients received extended surgical resection later, and all the 59 patients showed no recurrence during the followed up (range, 3 ～ 30 months) using endoscopy. Conclusion Endoscopic treatment is a safe, effective, valuable method for the management of duodenal lesions.

Establishment of heat acclimatization model in rabbits and its pathophysiological characteristics / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To establish an effective and stable rabbit heat acclimatization model for the experiment of heat acclimatization mechanisms.</p><p><b>METHODS</b>Sixteen healthy male rabbits were divided into heat acclimatization group and control group randomly (n = 8). Heat acclimatization (HA) group was kept in simulation chamber with dry bulb temperature of (36 +/- 1) degrees C, wet bulb temperature of (29 +/- 0.5) degrees C, black-bulb temperature of (40 +/- 1.0) degrees C, 100 min/day for 21 days. Control group was kept in the room with temperature of 20 degrees C and relative humidity < 60% during 20 days, then removed into simulation chamber on day 21 to estimate and monitor the rectal temperature together with the heat acclimatization group. Venous blood of control and heat acclimatization group before and after heat exposure on the 1st day, 11th day and 21st day were collected to detect levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6) and heat shock protein 70 (HSP70) by ELISA analysis.</p><p><b>RESULTS</b>(1) Rectal temperature: There was no significant change in control group during 21 days. In heat acclimatization group, it increased (2.07 +/- 0.43) degrees C after the 1st exposure, and increased (1.78 +/- 0.37) degrees C after the 11th exposure, the range of increasing decreased (0.29 +/- 0.09) degrees C. After the 21st exposure, it increased (1.52 +/- 0.29) degrees C, which was (0.55 +/- 0.14) degrees C lower than that of the 1st (P < 0.05),and (0.53 +/- 0.14) degrees C lower to that of the control group under 1st heat stress (P < 0.05); (2) The level of TNF-alpha after the 1st exposure increased significantly (P < 0.05), but didn't raise along with the exposure times. And fell back to the original level after the 11th and 21st exposure. Compared with control group, the level of IL-6 increased after the 1st, 11th and 21st exposure (P < 0.05), and maintained highly after the 11th and 21st exposure. Compared with the control group, the level of HSP70 increased dramatically with the heat exposure times. Significant increasing of (HSP70) could be detected after the 11th and 21st exposure (P < 0.05), but there was no difference to that of the 1st exposure.</p><p><b>CONCLUSION</b>Prolonged or repeated exposure to heat stressful environmental conditions can reduce the physiological strain, improve heat tolerance, elicits heat acclimatization.</p>

Promoting male circumcision in China for preventing HIV infection and improving reproductive health / 中华男科学杂志

The incidence of heterosexually transmitted HIV infection is rapidly increasing in China, which reached 44.7% among the HIV-positive patients in 2007. With a view to the reduction of HIV transmission and improvement of reproductive health in the Chinese population, this paper introduces the latest evidence obtained from the international epidemiological studies and randomized controlled clinical trials on the preventive effect of male circumcision (MC) on HIV transmission, and elucidates the cellular and molecular mechanisms of HIV transmission through the foreskin. Four studies published during 1997-2007 demonstrated that the mean prevalences of redundant prepuce and phimosis in 15,109 Chinese males aged 3-23 years in 4 areas of China were 43.90 and 11.55% , respectively, while the rate of MC was only 2.66%. As MC is a simple, inexpensive and highly effective technique in HIV prevention, we appeal to the policy-makers in China to conduct a practical program for promoting MC and enhancing male productive health in combination with other approaches to the prevention of HIV infection. MC for neonates, children, adolescents and adults should be included in the health insurance program, and free and timely MC should be performed for the male adults with the high risk of HIV infection and the normal ones whose wives are HIV-positive. Further investigations should be carried out on the epidemiology of redundant prepuce and phimosis, the acceptance and socio-cultural context of MC and the development of simpler and safer methods for MC.

Successful treatment of high-flow priapism by selective arteriographic embolization of the pudendal artery / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnosis and treatment of high-flow priapism (HFP).</p><p><b>METHODS</b>Four cases of HFP following blunt trauma to the penis or perinea underwent diagnostic examination by colour-flow Doppler ultrasound and/or superselective pudendal arteriography, which revealed bilateral arteriocorporal fistula in 1 case and monolateral in the other 3. Penile detumescence was obtained in 2 cases by superselective bilateral/monolateral arteriographic embolization of the pudendal artery with absorbable gelatin</p><p><b>RESULTS</b>The former 2 cases effected an immediate recovery of the sponge, while the other 2 cases received conservative treatment. Erectile function, able to perform normal sexual intercourse in approximately 2 months. But in the latter 2, follow-up revealed unsatisfactory potency.</p><p><b>CONCLUSION</b>Superselective arteriographic embolization with absorbable gelatin sponge can provide a safe, selective and effective treatment for HFP patients.</p>

Effects of topical application of insulin on the wound healing in scalded rats / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effects of topical application of small dose of insulin on the wound healing of the scalded rats, so as to explore its mechanism.</p><p><b>METHODS</b>The rats employed in the study were subjected to deep partial thickness burn and were divided into group A (with subcutaneous injection of isotonic saline into the rat wounds as control), B and C (with subcutaneous injection of 0.1 U and 1 U insulin in the rat wounds respectively) and D (with subcutaneous injection of 0.1 U insulin in the rat abdomen as control). The wound healing time and wound healing rate were assessed every other day after 3 postburn days (PBDs). The histological changes of the wounds after injection were examined, the changes in the cell cycle of epidermal cells in the wound were analyzed by flow-cytometry, and blood glucose concentration of each group was determined.</p><p><b>RESULTS</b>The wound healing time in group B (18.36 +/- 4.12 d) was significantly shorter than that in other groups (A: 24.57 +/- 5.19 d, C: 21.46 +/- 2.97 d, D: 24.50 +/- 1.05 d, P < 0.01). The wound healing rate of the rats in group B in 5, 9, 11, 13, 15, 17 and 19 PBD was obviously higher than that in group A, and was markedly higher than that in group C on 17 PBD (P < 0.05 - 0.01). The epithelial layer was thinner with less epidermal nails but much more fibroblasts in epidermal layer in group A, while the epithelial layer was thicker with abundant epidermal nails in group B and C with many fibroblasts in the dermis. The amount of cells in S phase at 4 PBD in group B was dramatically higher than that in group A, and cells in G2M phase at 4 - 5 PBD in group B was also higher than that in group A and C (P < 0.05 - 0.01). The blood level of glucose in group A and B fluctuated between 3.42 to 4.62 mmol/L at 24 PBH, while that in group C and D decreased obviously 1 hour after injection (P < 0.01), but gradually returned to normal 4 hours after injection.</p><p><b>CONCLUSION</b>Local injection of small dose of insulin may accelerate burn wound healing due to its role in promoting the proliferation and division of the repairing cells.</p>